University of Rochester Return to Work Coord - 225056 in Rochester, New York
Return to Work Coord
Full Time 40 hours Grade 053 HR Admin Svc-Leave Admin
8 AM-5 PM
Clinical oversight and analysis of assigned employee claims involving Workers’ Compensation, Short-Term Disability, Long-Term Disability, FMLA and other University Leave requests. Demonstrates comprehensive case management experience by providing consultation and guidance for OSHA Recordkeeping, Hearing Conservation, Ergonomics, Workplace Accommodations and Return to Work Plans. Promotes the HR Experience through the HR Values of Respect, Integrity, Inclusion, Performance Excellence and Engagement. Consistently demonstrates the 15 HR Experience Behaviors categorized under the five dimensions of ‘One Inclusive Team, Performance Excellence, Leading with Integrity, The HR Experts and Valued Customer Resource’.
Under general direction but with latitude for exercise of independent judgment:
Leave Administration – Clinical Advising
Monitors clinical aspects of assigned claims for the University of Rochester’s Leave Programs (WC, STD, LTD, LOA, & FMLA). Directs actions and initiates case management plans within defined parameters to expedite claim closure and injured/ill worker’s safe return to work. This requires interactions and collaboration with medical case managers, treating professionals, department administrators, HR Business Partners, employees and third party administrators. Clarifies medical documentation with treating professionals to ensure return to work plan and/or restrictions are clear and concise. In conjunction with Clinical Advisor – Leave Administration, evaluates the Task Analysis / physical requirements of the job to determine the UR’s ability to accommodate the requested accommodation/return to work plan. If physical requirements require further documentation, enlists services of University’s Environmental Health and Safety team for force gauge measurements, noise levels, or air quality testing.
Supports goals of the University’s Return to Work Program (RTW) for all leave programs (WC, STD, LTD, FMLA) to allow for a safe return to work for employees recovering from work-related or non-work injuries/illnesses. Monitors and assess case-loads and activities of medical case managers, making recommendations about individual return to work plans based on medical notes and job requirements. Solicits and identifies transitional work assignments for the Return to Work program. Maintains the documentation (Job Description and Task Analysis forms) for these assignments to identify matches to injured/ill employee’s physical capabilities to ensure safe placement and success in the transitional assignment. Maintains the Return to Work Transitional Assignments Log, preparing 610/800 forms as required. Facilitates communication between injured/ill worker, treating professional, department administrators and various University departments, such as Human Resources and Labor Relations, as needed. Communicates potential ADA and ADAAA related concerns to Human Resources, Legal and Intercessor. Creates and maintains crucial documentation related to all interactions with employees, managers, administrators, and business partners related to Leave Administration or RTW issues for use as needed for Union Grievance or Division of Human Rights issues. Represents the University in these hearings as requested by Legal Counsel. Makes recommendations for change in policies and assists with the implementation of procedural changes, as necessary.
Workers’ Compensation RTW Program and Return to Work Coordination
Collaborates with University’s WC Leave Administration staff to investigate, monitor and serve as a resource in determining compensability of injuries/ illnesses. Monitors WC claims for necessity of surveillance, nurse case manager/ vocational and rehabilitation counselor assignment and active treatment plans to facilitate return to work. Monitors Managed Care Network (MCN) MG-2 approval/denial process for compliance to timeliness and adherence to the NYS Medical Treatment guidelines. Provides consultation to MCN for direction of complex approvals/denials as needed. Responds to emergencies that may involve visiting impacted employee in the Emergency Room to expedite serious work related injuries. Assists with preparation of claims for adjudication and ensure incidents and treatment is documented for OSHA compliance and to ensure proper notification to the WCB.
Under direction of Clinical Advisor – Leave Administration oversee Independent Medical Exams (IME) process for assigned claims by identifying required documentation (medical reports, imaging studies, operative reports) and appropriateness of requested exam. Monitors outcome/reports from IME’s for completeness and need for addendums. Monitors use of opioids and prescription medications for assigned WC cases. Directs resolution for billing issues between Pharmacy Benefit Manager and Gallagher Bassett. Makes recommendations for weaning of medications as necessary.
Assists, as needed, with review/ maintenance of the University’s OSHA 300 Log, advising WC staff of corrections required for lost time, restricted duty, OSHA recordability and correct identification. Requires review of every medical note and C-11 form filed by the WC staff. Serves as a representative of the University for all assigned Workers’ Compensation Board (WCB) hearings as requested by defense counsel.
Clinical Advising Where No Leave is Requested
Provides consultation and guidance based on medical knowledge to Office of General Counsel, HR Offices, and Intercessor regarding incumbent employee issues unrelated to leave claims to address performance issues that may be related to an underlying medical issues and displaying as behavioral issues, absenteeism issues and overall declining performance. Provides consultation when incumbent employee makes a request for workplace accommodations.
Maintains knowledge of medical, environmental health and safety, OSHA, NIOSH, WC and related regulations. Keeps abreast of proposed changes and reports potential impact to manager. Represents Leave Administration on internal University Committees. Represents the University on external boards and committees.
Bachelor's degree in clinical field (Nursing or other clinical function) and 3-4 years in clinical role. 2-3 years managing employment related claims (WC or disability). Knowledge of Medical Terminology, experience managing work-related or non-work related employee claims; or an equivalent combination of education and experience. Strong working knowledge of New York State Workers’ Compensation Law, Medical Treatment Guidelines and Medical Terminology required. Active License in medical field of training, Certification such as Certified Occupational Health Nurse Specialist, Certified Case Manager, Certified Occupational Hearing Conservationist, and Pulmonary Function Technologist, preferred but not required.
NOTE: This document describes typical duties and responsibilities and is not intended to limit management from assigning other work as required.
How To Apply
All applicants must apply online.
EOE Minorities/Females/Protected Veterans/Disabled